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1 DEBTOR FINANCE Please FAX signed application form back to va Business Finance on va Business Finance is pleased to accept your application with a view to providing you with a solution to your cashflow needs. Fast assessment of your application is facilitated by providing the information requested with your application. We are happy to accept applications where documents are to be forwarded within 14 days. Alternatively please complete the authority on the last page to enable us to obtain the necessary information from your accountant.

2 (Please give us your company details) Company Information Business and (including Trading Style and Trading ) Postcode Phone : Fax : Registered : ABN: ACN: Nature of Business: of Establishment: Related Companies: (Tell us about the people in your company) Directors / Shareholders / Partners 1. Full Director YES / NO Shareholder % 2. Full Director YES / NO Shareholder % 3. Full Direcctor YES / NO Shareholder % 4. Full Director YES / NO Shareholder %

3 (Tell us about your debtors) Customer References Customer Contact Person Phone Monthly Turnover 1. $ 2. $ 3. $ 4. $ 5. $ (Tell us about your suppliers) Supplier References Customer Contact Person Phone Monthly Turnover 1. $ 2. $ 3. $ 4. $ 5. $ (Tell us about your Company s financial position) Company Borrowings Facility Limit / Original Balance Current Balance of Lender 1. $ 2. $ 3. $ 4. $ 5. $

4 application (Please indicate if attached) Documentation included with 1. Aged debtor (sales) analysis as at last month end 2. Aged creditors (purchases) analysis as at last month end 3. Copies of major suppliers and customers terms and conditions of sale 4. Balance sheet and profit and loss for the last 2 year 5. Any sales literature you may have 6. Copy of Trust Deed (if applicable) 7. Sample of an invoice 8. Any additional information Have any of the Directors, Shareholders or Partners or a company they are or have been associated with: Have any current or past debts other than those to financial institutions that are or were in default of the payment arrangement? Ever been declared bankrupt or insolvent or petitioned for bankruptcy, been advised to seek bankruptcy or aware of anyone petitioning for their bankruptcy? A private company of which an administrator, receiver, manager and / or liquidator has been appointed or had a petition for winding up? A private company of which an administrator, receiver, manager and / or liquidator has been appointed or had a petition for winding up?

5 I / we of authorize va Business Finance to obtain from our accountants the following documents Financial Statements for the last 2 years Interim financial statements showing the current position Financial Statements should include the following: Profit and Loss Statement Balance Sheet Statements and notes that form part of annual accounts Aged Debtor Balance Aged Creditor Balance Auditor s report (if accounts have been audited) of Accountancy Firm Contact Person Phone Fax: va Business Finance acknowledges this authority is valid for 14 days from date hereof. Information requested after this time period will require an additional authority. va Business Finance may only obtain the documents listed above. Company Position Held Printed

6 PRIVACY ACT, 1988 CONSENT AND ACKNOWLEDGEMENT Please read carefully before signing. Where there is more than one applicant or guarantor, each applicant or guarantor is to sign. va Business Finance ACN ABN (the Originator), and the Relevant Parties listed below collect and use personal information about me/us (the personal information) to: assess my/our application for credit or my/our proposal to guarantee or provide security; if an application is successful, provide and administer the provision of credit to me/us and obtain a guarantee; assess the risk of providing lenders' mortgage insurance in respect of credit which may be provided to me/us (including the risk of the Guarantor(s) being unable to meet a liability that might arise under a guarantee); if insurance is provided, administer or vary any lender's mortgage cover provided; assess and manage risk, involving credit scoring and portfolio analysis; and comply with legislative and regulatory requirements. In order to do those things, the Relevant Parties may need to disclose the personal information as required by law or to: organisations involved in providing credit to me/us; organisations and persons described in paragraphs 1 to 9 below; each other and to the related companies of each; people considering acquiring or taking an interest in the business or assets of each; and organisations that carry out functions (on behalf of each or any of them) (such as trust managers, introducers, mailing houses, IT service providers, valuers, lawyers and other external advisers, conveyancers and collection agents); reinsurers; credit reporting agencies; referees, including my/our employer or legal and financial advisers; government and other regulatory bodies, including government agencies which administer land titles or revenue collection; ratings agencies; payment system operators; and other financial institutions, securitisers and credit providers). Collection of some of the personal information is required under the Financial Transaction Reports Act. If I/we do not provide any part of the personal information, it may not be possible to assess my/our application for credit or lenders' mortgage insurance, and as a consequence finance may not be provided to me/us. The information provided by me/us will be held by the Relevant Parties. In most cases, I/we may gain access to the information by contacting the Relevant Parties. However, such request should be first directed to the Originator on I/We agree that the Relevant Parties, any finance broker, finance originator, finance provider, and any other person or company who at any time provides or has any interest in the credit can do any of the following, unless the law says they can t even if I/we consent: 1. Commercial credit information Seek and use information from any business which provides information about the commercial worthiness of persons about me/us to assess my/our application for consumer or commercial credit. 2. Consumer credit information Seek and use a credit report containing information about me/us from a credit reporting agency to assess my/our application for consumer or commercial credit or to assess whether to accept me/us as guarantor(s) for credit provided under this application. 3. Collection of overdue payments Seek and use a credit report about me/us provided by a credit reporting agency to collect overdue payments from me/us. 4. Exchange of information between credit providers Seek from and use or give to another credit provider any information about my/our account, credit worthiness, credit standing, credit history or credit capacity. In particular, the Originator can provide a bank opinion on me/us. I/We understand this information may be used for any of the following purposes: To assess my/our credit worthiness To assess my/our application for credit To help me/us avoid defaulting on my/our credit obligations To notify a default by me/us To assist in the collection of overdue payments from me/us To exchange information with credit providers who are involved in a mortgage securitisation scheme To exchange information with credit providers as to the status of this loan 5. Exchange of information with advisers and other persons Seek from and use or give any personal or commercial credit information about me/us to any finance broker, finance originator, finance provider, financial consultant, accountant, lawyer, or other adviser acting in connection with any financing provided or proposed to be provided to me/us. 6. Provide information to credit reporting agencies Give to a credit reporting agency information about me/us for the following purposes: To obtain a consumer credit report about me/us; and/or To allow the credit reporting agency to create or maintain a credit information file containing information about me/us. The information may include: identity particulars; my/our application for credit or commercial credit the fact that credit has been applied for and the amount;

7 the fact that the Credit Provider or the Relevant Party is a current credit provider to me/us; payments which become overdue more than 60 days and for which collection action has commenced; advice that payments are no longer overdue in respect of any default which has been listed; advice that cheques drawn by me/us have been dishonoured more than once; in specific circumstances, that in the opinion of the Originator or the Credit Provider, I/we have committed a serious credit infringement; the credit provided to me/us by the Originator or the Credit Provider has been paid or otherwise discharged; or otherwise in connection with arrangements relating to lenders' mortgage insurance. 7. Provide information to Guarantor Provide any report or personal or credit information about my/our to any person who proposes to guarantee or provide security for, or has guaranteed or provided security (guarantor) to: decide whether to act as guarantor; or to keep the guarantor informed about the guarantee. 8. Provide information to trade insurer If my/our application is for commercial credit, I/we consent to a trade insurer obtaining a credit report about me/us containing consumer credit information, in order to assess whether to insure the Credit Provider for the loan given to me/us, or the risk of providing insurance or to assess my/our risk of defaulting under the loan. 10. Relevant Parties va Business Finance Pty Ltd ACN va Star Group Pty Ltd (and associated entities) ACN I/We consent to such personal information and/or credit information about me/us being used or disclosed to the organisations or persons for the purposes described in this consent and acknowledgement (even though some organisations may be overseas), including (without limitation): (a) another credit provider as outlined in paragraph 4; (b) persons referred to in paragraph 5 as outlined in that paragraph. The Originator, Relevant Parties and Trade Insurers (if any) may use the personal information to tell me/us about other products and services offered or distributed by the Originator, and the Relevant Parties (if any) or any organisation the Originator is affiliated with or represents. I/We may choose not to have the personal information used or disclosed for this purpose or to receive any direct marketing material by ticking this box or contacting the Manager on Applicant(s) Guarantor(s)

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